Small Bowel Obstruction

Definition

Small bowel obstruction means the small intestine is partially or totally blocked. When this happens, the contents of the intestine cannot properly get out of the body. Stools, fluid, and gas build up inside the intestine. This is a potentially serious condition that requires urgent medical care.

Causes

Bowel obstruction may be caused by a mechanical problem. In this case, something inside the body blocks the movement of material through the intestine.

It can also be caused by an ileus, which is when the intestine itself does not work right. This nonmechanical type of obstruction is called
paralytic ileus, or
pseudo-obstruction. It is often the cause of obstruction in infants and children.

Mechanical small bowel obstruction may be caused by:

Adhesions—scar tissue left behind, in most cases by previous abdominal surgery

Paralytic ileus pain is often less severe than mechanical small bowel obstruction.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The exam will include listening for bowel sounds in your stomach. Very high pitched bowel sounds heard through a stethoscope suggest mechanical bowel obstruction. Conversely, paralytic ileus often produces no bowel sounds.

Imaging tests are used to evaluate abdominal structures. These may include:

Treatment

Treatment depends on the cause and severity of the obstruction. You will usually require treatment by a specialist. Your doctor will also treat you for any underlying conditions that contribute to small bowel obstruction.

Initial Care

Before any surgical treatment or procedure can begin, you may need to be stabilized. This may include:

Monitoring and IV fluids—Observation at a hospital may be needed to see if the blockage will get better on its own. No food will be allowed and fluids will be given through an IV.

Nasogastric tube—A tube is inserted through the nose and into the stomach to remove fluids and gas, which can promptly relieve pain and pressure. It will be left in place until the intestines are working well.

Catheterization—A tube is placed in the bladder to drain and test urine.

After the blockage is relieved, nutrition is given through an IV or feeding tube until you are able to eat solid foods. Other treatment for small bowel obstruction includes:

Medications

Medications may include:

Pain relievers

Oral triple therapy—to reduce gas, bloating, and improve symptoms

Muscle stimulants—to promote muscle contraction in the intestine

Antibiotics—to treat bacterial infections

Surgery

Surgery may be needed if you do not respond to medical treatment, or in the following circumstances:

Intestinal strangulation, which may be caused by volvulus or intussusception

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.